Guideline Promoting Buprenorphine for Treatment of Chronic Pain: Transformative Yet Underdeveloped
Authors: Chinazo O. Cunningham, Joanna L. Starrels
Journal: Annals of Internal Medicine (2023)

EditorialsMarch 2023Guideline Promoting Buprenorphine for Treatment of Chronic Pain: Transformative Yet UnderdevelopedChinazo O. Cunningham, MD, MS and Joanna L. Starrels, MD, MSChinazo O. Cunningham, MD, MSNew York State Office of Addiction Services and Supports, New York, and Albert Einstein College of Medicine, Bronx, New York and Joanna L. Starrels, MD, MSAlbert Einstein College of Medicine, Bronx, New YorkAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0229 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their article, Sandbrink and colleagues summarize key points from the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense's (DoD) 2022 guidelines on the use of opioids in the management of chronic pain (1, 2). These recommendations are an important update in the changing and challenging landscape that clinicians and patients navigate to address chronic pain in the context of the worsening overdose epidemic (3). The updated VA/DoD guideline is both conservative and radical. It is conservative because much of the guideline remains consistent with the Centers for Disease Control and Prevention's guideline that cautions against initiating ...References1. Sandbrink F, Murphy JL, Johansson M, et al; VA/DoD Guideline Development Group. The use of opioids in the management of chronic pain: synopsis of the 2022 updated U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Ann Intern Med. 2023;176:388-97. doi:10.7326/M22-2917 LinkGoogle Scholar2. U.S. Department of Veterans Affairs, U.S. Department of Defense. VA/DoD clinical practice guidelines for the use of opioids in the management of chronic pain. U.S. Government Printing Office; 2022. Accessed at www.healthquality.va.gov/guidelines/Pain/cot/index.asp on 10 January 2023. Google Scholar3. Ahmad FB, Cisewski JA, Rossen LM, et al. Provisional drug overdose death counts. National Center for Health Statistics; 2023. Accessed at www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm on 22 January 2023. Google Scholar4. Dowell D, Ragan KR, Jones CM, et al. CDC clinical practice guideline for prescribing opioids for pain - United States, 2022. MMWR Recomm Rep. 2022;71:1-95. [PMID: 36327391] doi:10.15585/mmwr.rr7103a1 CrossrefMedlineGoogle Scholar5. Paulsen R, Modestino AS, Hasan MM, et al. Patterns of buprenorphine/naloxone prescribing: an analysis of claims data from Massachusetts. Am J Drug Alcohol Abuse. 2020;46:216-23. [PMID: 31825718] doi:10.1080/00952990.2019.1674863 CrossrefMedlineGoogle Scholar6. Substance Abuse and Mental Health Services Administration. Removal of DATA waiver (X-waiver) requirement. Accessed at www.samhsa.gov/medication-assisted-treatment/removal-data-waiver-requirement on 22 January 2023. Google Scholar7. National Academies of Sciences, Engineering, and Medicine. Medications for Opioid Use Disorder Save Lives. National Academies Pr; 2019. Accessed at https://nap.nationalacademies.org/catalog/25310/medications-for-opioid-use-disorder-save-lives on 22 January 2023. Google Scholar8. Tesema L, Marshall J, Hathaway R, et al. Training in office-based opioid treatment with buprenorphine in US residency programs: a national survey of residency program directors. Subst Abus. 2018;39:434-40. [PMID: 29513136] doi:10.1080/08897077.2018.1449047 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: New York State Office of Addiction Services and Supports, New York, and Albert Einstein College of Medicine, Bronx, New YorkAlbert Einstein College of Medicine, Bronx, New YorkDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0229.Corresponding Author: Chinazo O. Cunningham, MD, MS, New York State Office of Addiction Services and Supports, 501 7th Avenue, 8th Floor, New York, NY 10018; e-mail, chinazo.[email protected]ny.gov.This article was published at Annals.orgon 14 February 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline Friedhelm Sandbrink , Jennifer L. Murphy , Melanie Johansson , Juli L. Olson , Ellen Edens , Jamie Clinton-Lont , James Sall , Christopher Spevak , and Metrics Current IssueMarch 2023Volume 176, Issue 3Page: 419-420KeywordsOpioid use disorderOpioidsPainPain managementTreatment guidelines ePublished: 14 February 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...